HYPERTENSION
Hypertension is a common disorder characterized by a sustained elevation of systolic arterial pressure (top number) of 140 mm Hg or higher, or a diastolic arterial pressure (bottom number) of 90 mm Hg or greater, or both. Hypertension is divided into two categories: essential (or primary) hypertension and secondary hypertension. Research has shown that hypernatremia (elevated serum sodium) increases the volume of blood, which raises blood pressure. Primary hypertension may also develop from alterations in other bosy chemicals. For some clients who respond to stress at a higher degree, hypertension may be related to a higher degree, hypertension may be related to a higher release of catecholamines, such as epinephrine and norepinephrine, which elevates blood pressure. Others feel that hypertension may be caused by a deficiency of natriuretic factor (a hormone produced by the heart) causing arteries to remain in a state of sustained vasoconstriction.
However, there are successful treatments that do control the effects of the hypertension. Renal failure may also result from decreased circulation to the kidneys. Mild elevation may be treatable with nonpharmacologic therapy, which may include rest, reduction of stress, counseling, weight loss, reduction of sodium in the diet, limiting the drinking of alcohol and the elimination of smoking tobacco products. The size of the heart muscle increases from the outer layer of the epicardium to the inner layer of the endocardium. Hypertension causes the heart to pump against greater resistance, increasing its workload. Amphetamines- Birth Control pills- Cardiovascular disease- Cushing's disease- Genetic factors- Hyperthyroidism- Kidney failurePathophysiology: Regardless of whether a person has primary or secondary hypertension, the same types of organ damage and complications occur. Depending on the clients response to nonpharmacologic therapy, one of several antihypertensive drugs may be prescribed. An opthalmic examination may reveal vascular changes in the eyes, retinal hemorrhages, or a bulging optic disk. In addition to repeating the blood pressure measurements, an evaluation for hypertension by a medical doctor may include:- a physical examination, including an accurate medical history- lab blood work (may include kidney profile, thyroid profile, and adrenal gland function)- urinalysis- electrocardiogram- chest x-rayMedical Treatment: Currently there is no cure for hypertension that is not secondary to another disease or condition. Prognosis: If untreated, hypertension places a patient at high risk for the development of a disabling or fatal disease. Choice of treatment depends upon the patient's age, race, and medical history. A blood vessel may hemorrhage in the brain causing cerebrovascular problems. If cholesterol and triglyceride levels are increased, a diet low in saturated fats may be recommended. There are many different types of drugs with proven track records in the control of hypertension, such as Apresoline and Brodipine.
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